Enterovirus & Enterovirus D68

Enteroviruses are a common cause of infections that may be a mild illness, like the common cold (common Cold Viruses), or a severe illness with symptoms like polio. They cause more than 10 million infections each year in the United States and include the viruses that cause polio (Poliomyelitis), hand, foot and mouth disease (Hand, Foot, and Mouth Disease), aseptic viral meningitis, and a more recently described virus, Enterovirus D68 that is associated with acute flaccid myelitis causing weakness and paralysis in children.

The most common symptoms of enterovirus infection include cold like symptoms like runny nose and cough, red eyes (conjunctivitis), fever, headache, body and muscle aches, skin rashes and mouth blisters. Infants and persons with weakened immune symptoms may have more severe disease affecting the heart (myocarditis and pericarditis) and nervous system (meningitis, encephalitis, and acute flaccid paralysis).

Individuals infected with Enterovirus D68 that had severe disease initially had cold like symptoms that quickly progressed to muscle weakness and acute flaccid myelitis. However, not everyone infected with Enterovirus D68 develops severe disease.

Enteroviruses are most commonly transmitted by close personal contact with an infected person. The virus can be found saliva, stool, or blister fluid. Touching a surface that someone had sneezed on, shaking hands or changing diapers would expose you to the virus if you then touched your face or mouth without first washing your hands.

Diagnosis often requires testing clinical specimens collected by a physician. The physician may take fluid from a blister, throat swab, stool or rectal swab. In severe cases, fluid from the spinal cord may be necessary. Enterovirus D68 requires a special testing.

Some enterovirus infections may result in life long immunity. Other may only produce partial or temporary immunity. There are many enteroviruses that can cause the same symptoms but infection with one type does not protect you from another type.

There is no routine surveillance conducted on Enterovirus viruses in Hawaii. Transmission of these viruses occurs year round in Hawaii due to our warm climate and high numbers of visitors from around the world. Hand hygiene is the best defense for these infections.

The best method for prevention for enterovirus infections is frequent hand washing with soap and water. Hugging, kissing, or sharing drinks or food with infected persons should be avoided. Disinfecting dirty surfaces, soiled items and toys is especially important in pre-school settings.